Adénome de la vésicule biliaire avec aspect cholestérolose

Gallbladder adenoma is a benign, often asymptomatic tumor, discovered in 0.5% of cholecystectomy specimens. We report the case of a 79-year old woman, admitted with suspected acute pancreatitis of biliary origin. She received cholecystectomy. Gross examination showed a yellowish vegetative and friable lesion at the level of the gallbladder fundus, measuring 1,7 cm on the major axis. Histological examination showed tumor proliferation with papillary and tubular architecture, bordered by pseudostratified biliary-type epithelium Lamina propria was the seat of many clusters of foamy histiocytes. The diagnosis was tubular papillary biliary-type adenoma with low-grade dysplasia associated with cholesterolosis lesions. Adenomas of the gallbladder usually affect adult women. Clinically, they are often asymptomatic. They appear as sessile or pedunculated polypoid structures and projecting into the lumen of the gallbladder. Ultrasound or endoscopic ultrasonography can highlight these lesions and sometimes specify their nature in 5% of cases. Cholesterol polyps are always benign, accounting for nearly half of the cases, and are usually infracentimetric. In our case, the histological diagnosis was obvious but the presence of foamy histiocytes in the lamina propria was unusual. The entire lesion should be well studied histologically to detect high-grade dysplasia lesions or signs of invasion.Pan African Medical Journal 2016; 2

Gastrites chroniques à hélicobacter pylori: évaluation des systèmes OLGA et OLGIM

Helicobacter pylori (H pylori) gastritis presents a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.Keywords: Chronic gastritis, helicobacter pylori, atrophic gastritis, intestinal metaplasia, stagingPan African Medical Journal 2016; 2

Ostéochondrome solitaire de la symphyse pubienne de découverte fortuite

L'ostéochondrome est la tumeur osseuse bénigne la plus fréquente. Elle touche habituellement les métaphyses des os longs, particulièrement autour du genou et de l'humérus proximal. Il touche très rarement la symphyse pubienne avec fréquemment une symptomatologie atypique. Nous rapportons le cas d'un ostéochondrome de la symphyse pubienne empiétant sur la branche osseuse ilio-pubienne chez un homme de 35 ans, de découverte fortuite. Les explorations radiologiques, l'examen macroscopique et histologique confirment le diagnostic ainsi que l'absence de signe de malignité

Primary renal carcinoid metastasizing to distant sites 12 years after the initial diagnosis

Les carcinoïdes primitifs du rein sont rares avec une centaine de cas rapportés dans la littérature. Sur le plan histologique, il s'agit d'une tumeur bien différenciée dont la morphologie rejoint souvent celle des carcinoïdes dans les autres localisations. Nous rapportons un cas de carcinoïde primitif du rein survenant chez un homme de 41 ans, découvert à la suite de métastases hépatiques. La tumeur était particulière par son architecture tubulo-papillaire, suggérant à tort le diagnostic de carcinome papillaire du rein. Ce diagnostic a été redressé 12 ans après, à la suite de l'apparition d'autres métastases hépatiques, osseuses et pulmonaires.Pan African Medical Journal 2016; 2

Characterization of two polyvalent phages infecting Enterobacteriaceae

Bacteriophages display remarkable genetic diversity and host specificity. In this study, we explore phages infecting bacterial strains of the Enterobacteriaceae family because of their ability to infect related but distinct hosts. We isolated and characterized two novel virulent phages, SH6 and SH7, using a strain of Shigella flexneri as host bacterium. Morphological and genomic analyses revealed that phage SH6 belongs to the T1virus genus of the Siphoviridae family. Conversely, phage SH7 was classified in the T4virus genus of the Myoviridae family. Phage SH6 had a short latent period of 16 min and a burst size of 103 ± 16 PFU/infected cell while the phage SH7 latent period was 23 min with a much lower burst size of 26 ± 5 PFU/infected cell. Moreover, phage SH6 was sensitive to acidic conditions (pH < 5) while phage SH7 was stable from pH 3 to 11 for 1 hour. Of the 35 bacterial strains tested, SH6 infected its S. flexneri host strain and 8 strains of E. coli. Phage SH7 lysed additionally strains of E. coli O157:H7, Salmonella Paratyphi, and Shigella dysenteriae. The broader host ranges of these two phages as well as their microbiological properties suggest that they may be useful for controlling bacterial populations

Spectrum of acute hepatitis and its clinical outcome in a central region in Tunisia

Introduction:&nbsp;given the lack of studies on acute hepatitis (AH) in Tunisia, we carried out this study to find the etiological spectrum and clinical profile of AH and to investigate the impact of viral etiology on the outcomes of AH. Methods:&nbsp;retrospective descriptive study collecting all patients with AH from 2010 to 2017. The data were compared between two groups (viral AH and non-viral AH). Results:&nbsp;one hundred and three patient´s files were included. The average age of our patients was 30.15 years. An etiology was found in 92 patients (89.3%). The viral etiology was found in 70 patients (76.1%). Hepatitis A virus (HAV), Hepatitis A virus (HBV), Hepatitis A virus (HCV) and cytomegalovirus (CMV) were in the cause in 52, 16, 1 and 1 patient respectively. Elsewhere, it was toxic hepatitis in 10 patients (10.9%) including 7 of drug-related AH. Budd-Chiari syndrome and autoimmune hepatitis with acute onset were reported in 3 (3.3%) and 7 (7.6%) patients, respectively. Patients with viral AH were younger than those with non-viral AH (p = 10-³). There was more recourse to hospitalization for non-viral AH. Patients with viral AH had a higher mean ALT level than those with non-viral AH. The liver damage was more severe in the non-viral AH group with lower PT. There was more severe form, more transition to chronicity and more deaths in the non-viral AH group. Conclusion:&nbsp;the results found in our study concerning the distribution of the etiologies of AH as well as their evolutionary aspects are consistent with the data in the literature

Study of the antimicrobial activity of essential oils from the leaves of male and female Pistacia lentiscus against pathogenic microorganisms causing diseases in livestock

editorial reviewe

Power Point in Medical Education: The Interest of Hybrid Strategies to Pass from’’ Passive Power Point’’ to ‘’Active Power Point’’

Power point (PPT) software is used widely in education with nearly 250,000,000 PPT teachers daily worldwide [1]. It is an effective tool in medical education (especially in memorization and understanding); and is appreciated by teachers and learners [1]. However, despite the respect of the classic PPT teaching rules, it might be boring (and therefore demotivating) when the teacher is content to read only the slides. To avoid this pitfall, motivating strategies exist by creating the concept of ‘’Action-Feedback-Interaction’’ (AFI). The description of these strategies is scattered in the literature in university pedagogy and is limited to one method in medical education called’’ Handout’’ [2].The aim of this work is to describe these strategies through a review of the literature and the experience of the authors

Malignant transformation of an urachal cyst

A 27-year-old man presented to our hospital for abdominal pain and a cheesy discharge from the umbilicus which lasted for a few days. He was afebrile. The physical examination revealed periumbilical tenderness and discharge from the umbilicus. There were no signs of general infection. Otherwise, he had neither specific symptoms nor a palpable abdominal mass. Pelvic computerized tomographic (CT) scanning) confirmed the presence of a cyst in the midline of the abdominal wall, with communication with the bladder and peripheral calcification. The mass was infiltrated to the perivesical fat (Figure 1). The patient was prepared for surgery. During laparotomy, a urachal cyst with the cuff of the bladder dome were removed (Figure 2). Recovery was unremarkable. The resected specimen was a partial cystectomy specimen with perivesical fat and the median umbilical ligamen